HRS 2026 – Dr Enrico Ferro (Beth Israel Deaconess Medical Center, Boston, MA) returns to discuss findings from a large single-centre comparative safety analysis of pulsed field ablation (PFA) versus radiofrequency (RF) ablation for atrial fibrillation, originally presented at EHRA 2026 in Paris as a Young Investigator Award submission.

Conducted at one of the highest-volume PVI centres in the US, this study enrolled approximately 4,000 patients — 2,000 treated with PFA and 2,000 with RF ablation — to evaluate real-world stroke rates across two distinct treatment eras. Notably, the analysis includes a sizeable cohort of Sphere-9 cases alongside Farapulse, enabling early cross-platform comparisons within the PFA class.

Interview Questions:

1. What prompted this comparative safety analysis, and why is stroke risk a particular focus when evaluating PFA?
2. What were the key findings around stroke rates between the PFA and RF cohorts, and how did event distribution evolve over time?
3. Your data suggest a possible PFA class effect across platforms; what are the implications of that, and how confident can 4. we be in that signal at this stage?
4. Posterior wall isolation was performed far more frequently in PFA cases; how might more extensive ablation factor into the stroke risk observed?
5. What are your take-home messages for electrophysiologists using PFA, and what will the next phase of this analysis look at?

Recorded on-site at HRS 2026, Chicago.
Editors: Jordan Rance
Videographer: Oliver Miles
Support: This is an independent interview produced by Radcliffe Cardiology.